Over the last two weeks physicians at Monroe Carell Jr. Children’s Hospital at Vanderbilt have seen two cases of what is believed to be children playing the “choking game.” The dangerous game involves a child who is choked until he or she loses consciousness. Safety experts warn that children who play this game may have very little idea of how dangerous it can be.

“The choking game is not a game at all. It is the act of purposely hurting your brain in order to get a brief rush or high. The choking game can lead to brain damage, seizures and head trauma. And in some cases the game is fatal,” says Purnima Unni, Pediatric Trauma Injury Prevention Program Coordinator.

Choking game or fainting game

This game is popular among 9- to 16-year-olds. These adolescents are generally high-achieving in academics and sports and do not want to risk getting caught with drugs or alcohol. In the game they either strangle themselves or each other, sometimes at school, parties, or sleepovers, in order to get a high.

"This is a real problem with potentially devastating outcomes,” said Pediatric Emergency Medicine physician Kimberly Naftel, M.D. “Children don’t seem to realize the serious harm they can do to themselves while playing this game. Children who have experimented with this game have suffered irreversible damage such as loss of consciousness, behavior changes, permanent brain damage, and even death.”

The “choking game” has been around for decades and goes by many names such as the “fainting game,” “pass-out game,” “knock-out,” “dream game,” or “space monkey.”

“Children don’t realize that this game is life threatening and the rush is addictive in nature,” said Unni. “They may start off doing this with friends to get high but then start attempting this on their own, using a rope or belt as a makeshift noose. This can be extremely dangerous.”

Parents, educators, health care providers or peers may observe any of the following signs that can indicate a child has been involved in the choking game:

Discussion of the game or its aliases

Bloodshot eyes

Marks on the neck

Wearing high-necked shirts, even in warm weather

Frequent, severe headaches

Locked doors

Disorientation after spending time alone

Increased and uncharacteristic irritability or hostility

Ropes, scarves and belts tied to bedroom furniture or doorknobs or found knotted on the floor

Peer-pressure and curiosity are big reasons children and teens may try this activity.

The most important thing you can do to prevent injury is to discuss how deadly this “game” is with your kids early on. Be proactive and share with them the dangerous consequences of what can happen if they play this game even once.